RESUMEN
The International Classification of Diseases (ICD) provides a common language for use worldwide as a diagnostic and classification tool for epidemiology, clinical purposes and health management. Since its first edition, the ICD has maintained a framework distributing conditions according to topography, with the result that some complex conditions, such as allergies and hypersensitivity disorders (A/H) including anaphylaxis, have been poorly represented. The change in hierarchy in ICD-11 permitted the construction of the pioneer section addressed to A/H, which may result in more accurate mortality and morbidity statistics, including more accurate accounting for mortality due to anaphylaxis, strengthen classification, terminology and definitions. The ICD-11 was presented and adopted by the 72nd World Health Assembly in May 2019, and the implementation is ongoing worldwide. We here present the outcomes from an online survey undertaken to reach out the allergy community worldwide in order to peer review the terminology, classification and definitions of A/H introduced into ICD-11 and to support their global implementation. Data are presented here for 406 respondents from 74 countries. All of the subsections of the new A/H section of the ICD-11 had been considered with good accuracy by the majority of respondents. We believe that, in addition to help during the implementation phase, all the comments provided will help to improve the A/H classification and to increase awareness by different disciplines of what actions are needed to ensure more accurate epidemiological data and better clinical management of A/H patients.
Asunto(s)
Anafilaxia , Síndrome de Hipersensibilidad a Medicamentos , Anafilaxia/diagnóstico , Anafilaxia/epidemiología , Humanos , Clasificación Internacional de Enfermedades , Organización Mundial de la SaludRESUMEN
In the past, asthma was considered mainly as a childhood disease. However, asthma is an important cause of morbidity and mortality in the elderly nowadays. In addition, the burden of asthma is more significant in the elderly than in their younger counterparts, particularly with regard to mortality, hospitalization, medical costs or health-related quality of life. Nevertheless, asthma in the elderly is still been underdiagnosed and undertreated. Therefore, it is an imperative task to recognize our current challenges and to set future directions. This project aims to review the current literature and identify unmet needs in the fields of research and practice for asthma in the elderly. This will enable us to find new research directions, propose new therapeutic strategies, and ultimately improve outcomes for elderly people with asthma. There are data to suggest that asthma in older adults is phenotypically different from young patients, with potential impact on the diagnosis, assessment and management in this population. The diagnosis of AIE in older populations relies on the same clinical findings and diagnostic tests used in younger populations, but the interpretation of the clinical data is more difficult. The challenge today is to encourage new research in AIE but to use the existing knowledge we have to make the diagnosis of AIE, educate the patient, develop a therapeutic approach to control the disease, and ultimately provide a better quality of life to our elderly patients.
RESUMEN
Introdução: As doenças alérgicas têm prevalência extraordinária em todo o mundo, e a incidência de alergia é crescente em to¬dos os lugares!-7. Como os processos alérgicos e imunol¬gicos sobrepõem todos os sistemas orgânicos, nem sempre a alergia é ensinada nas escolas de medicina como uma disciplina separada. Realmente, a falta de reconhecimento da especialidade e da necessidade de ensinar as doenças alérgicas e imunológicas resulta no fato de a alergia não ser incluída em certos currículos de medicinas. Com a estimativa de que 22 pt por cento da população global tem doenças alérgicas e imunológicas, está na hora de reconhecer e fortalecer a educação em alergia e imunologias. A World Aflergy Organization, uma aliança de 74 sociedades nacionais e regionais de alergia, criou este documento consensual para estabelecer diretrizes educacionais que aplicadas mundialmente, para identificar e corrigir as deficiências do treinamento em alergia e para definir metas de treinamento apropriadas. Ao criar este consenso, é reconhecido que cada país tem seus próprios princípios e metas de educação médica nos níveis de graduação e pós-graduação. Este documento define o que um médico deve saber para tratar pacientes alérgicos.